Individual
BRADLEY ALLEN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA, MS
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
9261 FOX AVE, ALLEN PARK, MI 48101-1507
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704265869
MI
Other
Enumeration date
09/16/2013
Last updated
10/17/2013
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